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HomeMy WebLinkAboutBLD2021-00012 Addition - BLD Application - 1/5/2021 MASON COUNTY COMMUNITY SERVICES Permit No-Z III2 )L— 661) 1, PERMIT ASSISTANCE CENTER: .BUILDING•PLANNING•PUBLIC HEALTH•FIRE MARSHAL 615 W.Alder Street,Shelton,WA 98584 ,."aifre� "r I V E D P4pnegn:(360)427-9670 ext.352•Fax:(360)427-7798 Phone . 0 WN J,BvIfair.(360)275-4467•Phone Elma:(360)482-5269 J A N 0 2021 BUILDING PERMIT APPLICATION PRO) tTY OWNER INFORMATION: CONTRACTOR INFORMATION: NAME: Tt-D 1` r-A L_ NAME: -1OS f{ Q(A AR bE:1ZS MAILING ADDRESS: 3US_ E /K W MAILING ADDRESS: I E. 14Wi N CITY: GiG (4PO166 STATE:WA ZIP: 33S CITY: S NEL70!N STATE:WA ZIP: CJ 9 S$ PHONE#1: 'L5 3 327 3 Sq Z. PHONE:36 0 3SS 32-96 CELL: PHONE#2: EMAIL :JOSH &_CUSTOM&(,tA Q&r S COM EMAIL:TMIJ,EAL Q OWCA-S7 NET L&I REG#CU.S70M *C.82LIe-3 EXP.S lA/ T-2 PRIMARY CONTACT: OWNER CONTRACTOR❑ OTHER❑ NAME EMAIL .� r� 1 L 6 c 65 MAILING ADDRESS _� C.`a -t tk0 C( ►'i N L4,/ CITY i.(� IA LIZ STATE jam,— ZIP &:='i PHONE Y a 3 J 2 7 `3 4y'2.. CELL tMiE: PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number) J 2 I t q --S3 00 1 O& ZONING LEGAL DESCRIPTION(Abbreviated) FIRE DISTRICT SITE ADDRESS 45-65- C-r i3oglq 120 PrD CITY S UE7L-7oAl DIRECTIONS TO SITE ADDRESS ti10YLS7��V� O%�� [E3'(/�- _ IS THE PROJECT WITHIN 300 FT OF SLOPE(S)GREATER THAN 14%: YES[] NO SNOW LOAD: psf IS PROPERTY WITHIN 200 FT OF THE FOLLOWING: (Check all that apply): SALTWATER❑ LAKE ❑ RIVER/CREEK❑ POND ❑ WETLAND❑ SEASONAL RUNOFF❑ STREAM❑ TYPE OF WORK: NEW❑ ADDITION K ALTERATION ❑ REPAIR❑ OTHER ❑ USE OF STRUCTURE(Residence,Garage,Com ercial Bldg,Etc) !��4& � A'd jl IS USE: PRIMARY 0 SEASONAL[1 NUMBER OF BEDROOMS_ ER OF BATHROOMS 'L HEATED STRUCTURE? YES(Whole Bldg) ❑ YES(Part[,]of Bldg) ❑ NO ❑ DESCRIBE WORK b-t b'7i a N o F FE�N R OQ r A O 6F I , S?! A)C, t SQUARE FOOTAGE: (proposed) 1 ST FLOOD i�sq.ft. 2ND FLOOR sq.ft. 3RD FLOOR sq.ft. BASEMENT sq.ft. DECK_'_ ' sq.ft. COVERED DECK sq.ft. STORAGE sq.ft. OTHER sq.ft. GARAGE sq.ft. Attached❑ Detached❑ CARPORT sq.ft. Attached❑ Detached❑ MANUFACTURED HOME INFORMATION: *4 COPIES OF THE FLO AN REQUIRED* MAKE MODEL YEAR LENGTH WIDTH BEDROOMS BATHS NUMBER ENVIRONMENTAL HEALTH: SEWAGE/SEWER SOURCE: SEPTIC ❑ SEWERX / NEW❑ EXISTING ❑ PLUMBING IN STRUCTURE? YES ❑ NO K If yes, attach completed Water Adequacy Form PERIMETER/FOUNDATION DRAINS PROPOSED? YESX jO❑ EXISTING SQ.FT. EXISTING BEDROOMS I- PROPOSED BEDROOMS _ TOTAL BEDROOMS OWNER acknowledges that'submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below.I declare that I am the owner and I further declare that I am entitled to receive this permit and to do the work as proposed.I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project. The owner or legal representative,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection. This permit/application becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATION OF WORK ON THIS PERMIT IS BY MEANS OF INSPECTION. INACTIVITY OF THIS PERMIT AP�ICATION_Of 180 DAYS OF MORE WILL CAUSE THE APPLICATION TO BE EXPIRED. (MASO LI COUNTY CODE 14.08.42) SUbmt x i%", I rC 1-5-2oZI Signature of OWNER(Must be signed by the OWNER) Date DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT 3-t o-ZoL PLANNING DEPARTMENT FIRE MARSHAL PUBLIC HEALTH MASON COUNTY COMMUNITY SERVICES Permit Nol�l"d aWl- 0I A PERMIT ASSISTANCE CENTER: =1:)UILUIIV =r�i�'iNr'4'11t1G *FIRE MARSHAL 615 W. Alder St-Shelton, WA 98584 RECEIVED www.co.mason.wa.us Phone Shelton:(360)427-9670 ext 352- Fax:(360)427-7798 JAN 0 5 2021 ne Belfair.(360)275-4467- Phone Elma:(360)482-5269 ING & MECHANICAL PERMIT APPLICATION,der Street OWNE ATION: CONTRACTOR INFORMATION: '. NAM N EAL NAME: Six &RARDez's MAIL ADDRESS: 3 20 S q- MAILING ADDRESS:401 Ej CITY: GCG p FATE: WA ZIP:98335 CITY: STATE: 1�(J�NZIP: I'PHONE: 2 S3 3 Z7 31 °I Z PHONE:360 353 32$6 CELL: 2ad PHONE: EMAIL : OSµ 04- MqQU�'1COA'ZS Cdtiy EMAIL: TeDIUG;R (&WMCAST- NET L&I REG#C 4S70 6tC 3 u k3 EXP. PARCEL INFORMATION: PARCEL NUMBER(12 Digit Number): �'Z �Cj — 'S 3--- 0 O 10(C Zoning: LEGAL DESCRIPTION(Abbreviated): SITE ADDRESS: SSS OS-A) CITY: / 0 DIRECTIONS TO SITE ADDRESS: � � N�i AT-lE' ICLS��'N/E TYPE OF JOB: NEW ADD_ C_ALT REPAIR OTHER USE OF BUILDING LOCATION OF FIXTURES/UNITS—1sT FLOOR 2ND FLOOR BASEMENT GARAGE OTHER PLUMBING FIXTURES(SHOW NUMBER OF EACH) MECHANICAL UNITS Type of Fixture No.of Fixtures Fees Fuel Type:Electric LPG Natural Gas Ductless_ Toilets Type of Unit No.of Units Fees Bathroom Sink Furnace Bath Tubs Heat Pump Showers I Spot Vent Fan � Water Heater A, Propane Tank Clothes Washer Gas O Kitchen Sinks Woo Gas/P llet Stove Dishwasher Kitchen aust Hood Hose bibs Dryer Vent Other Solar Panel Other Base Fee Base Fee TOTAL PLUMBING TOTAL MECHANICAL OWNER acknowledge submission of inaccurate information may result in a stop work order or permit revocation.Acknowledgement of such is by signature below. I declare that I am the owner,owners legal representative,or contractor. I further declare that I am entitled to receive this permit and to do the work as proposed. I have obtained permission from all the necessary parties,including any easement holder or parties of interest regarding this project.The owner or authorized agent represents that the information provided is accurate and grants employees of Mason County access to the above described property and structure(s)for review and inspection.This permittapplication becomes null&void if work or authorized construction is not commenced within 180 days or if construction work is suspended for a period of 180 days. PROOF OF CONTINUATI N OFTHIS PERMIT IS BY MEANS OF INSPECTION.INACTIVITY OF THIS PERMIT APPLICATION OF 180 DAYS WILL INVALID E THE APPLICATION. X � 20 u� Signature of Owner D to DEPARTMENTAL REVIEW APPROVED DATE DENIED DATE TAGS/NOTES/CONDITIONS BUILDING DEPARTMENT J TL 3-10-V PLANNING DEPARTMENT FIRE MARSHAL Rev:1/27/2016 JBN Name ~ Parcel# 12i 1 J --S 3-001 O G� BLD# 2b Mason County De > nt of Community Development Small Parcel Stor anagement Application/Worksheet (page 1 of 2) Per Mason County CICLle 14,Chapter 14.48 a stormwater site plan is required whenever a building application is made for residentiallopment, or redevelopment', with more than 2,000 square feet of impervious surface 2. 'Redevelopment means,on an already developed site,the creation or addition of impervious surfaces,structural development including construction, installation or expansion of a building or other structure,and/or replacement of impervious surface that is not part of a routine maintenance activity,and land disturbing activities associated with structural or impervious redevelopment. 2Common impervious surfaces include,but are not limited to,rooftops,walkways,patios,driveways,parking lots or storage areas, concrete or asphalt paving,gravel roads,packed earthen materials,and oiled,macadam or other surfaces which similarly impede the natural infiltration of stormwater.Open,uncovered retention/detention facilities shall not be considered as impervious surfaces. To Calculate Impervious Surfaces Please Complete This Table Surface Type Length X Width = Area *All dimensions in feet Buildings X IJ X _ [� -2 Measurements for buildings are taken at the egy Am -2 X _ perimeter of the farthest projections (example: eaves/gutters) X = Driveways X X = Length of drive begins at the right of way X = Parking Areas X = X = Any paved, gravel or packed area per definition above table X = Patios/Walks X X _ ' Zj Any paved, gravel or packed area per definition above table X = Others X = X = If the total impervious area of the proposed site X = development is greater than 2000 square feet a Small Parcel Stormwater Site Plan is Required Total Impervious Surface Area (sum of all areas) j(�0 If the Total Impervious Surface Area is LESS THAN 2000 Square Feet,please read, acknowledge and sign below. Based Upon the information you have provided a Stormwater Site Plan IS NOT required for this development activity. OwnerBuilder/Agent Acknowledges that submission of inaccurate information may result in a stop work order or permit revocation. Acknowledgement of such is by signature below.I declare that I am the owner,owner's legal representative,or the contractor.I further acknowled e that the information provided is accurate and employees of Mason County are granted access to the above- described prope for revi w and inspection as may be required. X Own /Agent/Contractor(circle one)Date: If the Total Impervious Surface Area is GREATER THAN 2000 Square Feet,please re , acknowledge and sign the information provided on page 2 of 2. Page 1 of 2 \ RECEIVED \ NEW 120 o I \ PROPANE TANK PROPERTY LINE \ 45' RADIUS CIRCLE _ NEW ADDITION ,,.;;mow, �'� �" ',� ��..�y��EXTG. 17R1`✓EWAY�'�`"�-~.;f�;�=.:� -��r.•. .sr .,�`��".`'1 S "f';s'y.--•::G,tii'✓"S:`i" �-ram`}'•.`=ai.� .Sr \ / ,�xr ''�I'rs!.f- �-';I�ir�.-•,c\��>iv:'t"'rc`.[:...�S�ati-I o�,.�. T`'.>z;v4";..�e[�'•��` _. •L TBACKS ARE MEASURE© \ FROM THE FURTHEST PLANNINGPRC),�ECTION OF THE BUILDING 51TE PLAN- 1 Ex�s 5�-- 3 ld Zo2-1 - 0001 >lc1dt 4-1 51 TE ADDRE55 555 5 BOS'N RD. APPROVED SHELTo ROVED N, W,4 g8584 MASON OU sv PLANNING SITE PLAN Rt� 11 ;- 8E ON SITE PARG1. NUMSR CHANGES Si -; APPROVAL ::SOi3TH: By Date _Qa-aG_�f 1211q-53-00106 I